Rakesh, a 7-year old boy had itchy, excoriated papules on the forehead and the exposed pas of the arms and legs for 3 years. The disease was most severe in the rainy season and improved completely in winter. Most likely diagnosis is –
Correct Answer: Insect bite hypersensitivity
Description: papular uicaria- prurigo simplex- insect bite hypersensitivity papular uicaria is a chronic recurrent eruption of irritable uicated papules occuring in patients with accquired sensitivity to insect bites. usually incidence is seasonal coincides with biting habits of insects age of onset 2-7years clinical features:primary lesions wheals , papules, wheals surounted by papules with central hemorrhagic punctum. severe pruritus, scratched off crusted lesions sites of prediliction: exposed sites, depends on the clothing pattern of individual. complications: secondary bacterial infection, eczema, bullae, thickened patches treatment: antihistamines, avoiding insect bites. IADVL textbook of dermatology,diseases caused by ahropods,page 399
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